Ventricular septal defect electrocardiogram: Difference between revisions
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{{Ventricular septal defect}} | {{Ventricular septal defect}} | ||
{{CMG}}; '''Associate Editors-In-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]; Atif Mohammad, M.D., [[Priyamvada Singh]], [[MBBS]] | {{CMG}}; '''Associate Editors-In-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]; Atif Mohammad, M.D., [[Priyamvada Singh]], [[MBBS]] | ||
== Electrocardiogram == | == Electrocardiogram == | ||
The ECG changes reflect the [[size of shunt]] and degree of [[pulmonary hypertension]] | The ECG changes reflect the [[size of shunt]] and degree of [[pulmonary hypertension]] | ||
=== Small VSD === | === Small VSD === | ||
* Restrictive VSD, Qρ/Qѕ < 1.5/1.0 Qρ/Qs is pressure gradient between pulmonary and systemic circulation: EKG is normal. A few patients will have an rsr' in V1. | * Restrictive VSD, Qρ/Qѕ < 1.5/1.0 Qρ/Qs is pressure gradient between pulmonary and systemic circulation: EKG is normal. A few patients will have an rsr' in V1. | ||
=== Medium-sized VSD === | === Medium-sized VSD === | ||
* left atrial overload - broad notched P wave | * left atrial overload - broad notched P wave | ||
* Left ventricular overload - Deep 'Q' wave, tall 'R' wave, tall 'T' wave in lead V5 and V6 | * Left ventricular overload - Deep 'Q' wave, tall 'R' wave, tall 'T' wave in lead V5 and V6 | ||
* Atrial fibrillation can also be seen | * Atrial fibrillation can also be seen | ||
=== Large VSD === | === Large VSD === | ||
* In adults or adolescence with a large VSD and pulmonary vascular obstructive disease, LVH is absent because volume overload of the LV is no longer present. Large VSD will produce [[right ventricular hypertrophy]] with [[right axis deviation]]. At this point there is either an rsR' pattern in the right precordial leads, or more commonly, a tall monophasic R wave in the right precordial leads reflecting RVH. Also deep S waves in the lateral precordial leads and tall peaked P waves. | |||
In patients with an acquired infundibular stenosis, the EKG shows a pattern of RVH similar to the tracing of patients with [[tetralogy of Fallot]]. | |||
In patients with an | |||
== References == | == References == | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Cardiology]] | |||
[[Category:Congenital heart disease]] | |||
[[Category:Pediatrics]] | |||
[[Category:Disease]] | |||
[[Category:Needs overview]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 17:36, 8 January 2013
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Ventricular septal defect Microchapters | |
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Differentiating Ventricular Septal Defect from other Diseases | |
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Diagnosis | |
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ACC/AHA Guidelines for Surgical and Catheter Intervention Follow-Up | |
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Case Studies | |
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Ventricular septal defect electrocardiogram On the Web | |
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American Roentgen Ray Society Images of Ventricular septal defect electrocardiogram | |
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Risk calculators and risk factors for Ventricular septal defect electrocardiogram | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Keri Shafer, M.D. [2]; Atif Mohammad, M.D., Priyamvada Singh, MBBS
Electrocardiogram
The ECG changes reflect the size of shunt and degree of pulmonary hypertension
Small VSD
- Restrictive VSD, Qρ/Qѕ < 1.5/1.0 Qρ/Qs is pressure gradient between pulmonary and systemic circulation: EKG is normal. A few patients will have an rsr' in V1.
Medium-sized VSD
- left atrial overload - broad notched P wave
- Left ventricular overload - Deep 'Q' wave, tall 'R' wave, tall 'T' wave in lead V5 and V6
- Atrial fibrillation can also be seen
Large VSD
- In adults or adolescence with a large VSD and pulmonary vascular obstructive disease, LVH is absent because volume overload of the LV is no longer present. Large VSD will produce right ventricular hypertrophy with right axis deviation. At this point there is either an rsR' pattern in the right precordial leads, or more commonly, a tall monophasic R wave in the right precordial leads reflecting RVH. Also deep S waves in the lateral precordial leads and tall peaked P waves.
In patients with an acquired infundibular stenosis, the EKG shows a pattern of RVH similar to the tracing of patients with tetralogy of Fallot.